Utilizing an integrated infrastructure for outcomes research: a systematic review.

Area of Science:

• Health Informatics
• Outcomes Research
• Health Services Research

Background:

• Integrated health information infrastructures are crucial for modern healthcare research.
• Electronic health records (EHRs) capture valuable data for outcomes studies.
• The Regenstrief Institute has utilized an integrated EHR infrastructure for research since 1983.

Purpose of the Study:

• To evaluate the capacity of an integrated health information infrastructure to support outcomes research.
• To analyze the growth and impact of research utilizing this infrastructure over three decades.

Main Methods:

• Systematic review of 190 articles published from 1983-2012.
• Articles used data from an integrated EHR infrastructure across multiple provider organizations.
• Classification by study design, disease focus, and bibliometric data.

Main Results:

• Research spanned diverse areas including cognitive, cardiovascular, infectious diseases, chronic illness, and cancer.
• Publications and investigator numbers grew significantly, with increasing external collaborations.
• The infrastructure expanded to cover over 6 million patients, demonstrating high impact for clinical trials and comparative effectiveness research.

Conclusions:

• Integrated health information infrastructures foster high-quality observational studies and collaboration.
• These infrastructures promote a learning health system by enabling analysis of routine clinical data.
• Time and collaborative efforts are essential for realizing the full potential of integrated health information infrastructures.